Journal/Magazine Articles
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This collection contains original research articles, review articles and case reports published in local and international peer reviewed journals by the staff members of the Faculty of Medicine
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Item Charles Bonnet syndrome(SAARC Psychiatric Federation, 2015) Dissanayake, D.M.R.M.; Hewarathne, A.; Wijesinghe, C.A.; Amarasinghe, B.; Williams, S.S.A 41 year old married labourer presented with complex visual hallucinations for six months. He had reduced visual acuity, a subluxated lens, and two retained sutures from a previous surgery of the right eye and complete blindness of the left eye. His mental, physical and neurological examinations were unremarkable. Surgical correction of his visual impairment resulted in resolution of symptoms.Item Unusual presentations of reflex epilepsy in psychiatric practice: A case series(SAARC Psychiatric Federation, 2015) Kuruppuarachchi, K.A.L.A.; Kapugama, K.G.C.L.; Wijesinghe, C.A.No abstract availableItem “Muddling by googling” – Cyberchondria among outpatient attendees of two hospitals in Sri Lanka(Sri Lanka Journal of Psychiatry, 2019) Wijesinghe, C.A.; Liyanage, U.L.N.S.; Kapugama, K.G.C.L.; Warsapperuma, W.A.N.P.; Williams, S.S.; Kuruppuarachchi, K.A.L.A.; Rodrigo, A.BACKGROUND: The internet is widely used as a source of health information, and the negative effects of this practice is well documented. Cyberchondria, the unfounded escalation of concerns about common symptoms based on review of online information has been identified as a major concern. This area has not been studied in Sri Lanka. AIMS: We studied the prevalence, nature and effects of cyberchondria among outpatients in Sri Lanka. METHODS: Data was gathered from 300 outpatients, 150 patients each attending a government and private hospital in Western province using a self-administered questionnaire. RESULTS: Out of 300 participants 178 were female and the average age was 42 years. Only 24% of the participants used the internet as an information source on health related issues. The prevalence of cyberchondria was 16.3% in our study population. Cyberchondria was significantly more common among outpatients of the private hospital. A majority of patients who made a self-diagnosis using online information had made an incorrect diagnosis. One third of internet users felt anxious after searching about their symptoms and 34% sought further medical advice following internet use. CONCLUSIONS: The possible negative effects of online health information is a concern in Sri Lanka. Further studies and public education regarding this area in Sri Lanka are required.Item A Randomized Controlled Trial of a brief Intervention for delayed psychological effects in snakebite victims(Public Library of Science, 2015) Wijesinghe, C.A.; Williams, S.S.; Kasturiratne, A.; Dolawaththa, N.; Wimalaratne, P.; Wijewickrema, B.; Jayamanne, S.F.; Isbister, G.K.; Dawson, A.H.; Lalloo, D.G.; de Silva, H.J.BACKGROUND: Snakebite results in delayed psychological morbidity and negative psycho-social impact. However, psychological support is rarely provided to victims. AIM: To assess the effectiveness of a brief intervention which can be provided by non-specialist doctors aimed at reducing psychological morbidity following snakebite envenoming. METHOD: In a single blind, randomized controlled trial, snakebite victims with systemic envenoming [n = 225, 168 males, mean age 42.1 (SD 12.4) years] were randomized into three arms. One arm received no intervention (n = 68, Group A), the second received psychological first aid and psychoeducation (dispelling prevalent cultural beliefs related to snakebite which promote development of a sick role) at discharge from hospital (n = 65, Group B), while the third received psychological first aid and psychoeducation at discharge and a second intervention one month later based on cognitive behavioural principles (n = 69, Group C). All patients were assessed six months after hospital discharge for the presence of psychological symptoms and level of functioning using standardized tools. RESULTS: At six months, there was a decreasing trend in the proportion of patients who were positive for psychiatric symptoms of depression and anxiety from Group A through Group B to Group C (Chi square test for trend = 7.901, p = 0.005). This was mainly due to a decreasing trend for symptoms of anxiety (chi-square for trend = 11.256, p = 0.001). There was also decreasing trend in the overall prevalence of disability from Group A through Group B to Group C (chi square for trend = 7.551, p = 0.006), predominantly in relation to disability in family life (p = 0.006) and social life (p = 0.005). However, there was no difference in the proportion of patients diagnosed with depression between the three groups (chi square for trend = 0.391, p = 0.532), and the intervention also had no effect on post-traumatic stress disorder. CONCLUSIONS: A brief psychological intervention, which included psychological first aid and psychoeducation plus cognitive behavioural therapy that can be provided by non-specialist doctors appeared to reduce psychiatric symptoms and disability after snakebite envenoming, but not depression or post-traumatic stress disorder. TRIAL REGISTRATION: Sri Lanka Clinical Trials Registry: SLCTR/2011/003.Item Tobacco smoking in persons with schizophrenia followed up at a teaching hospital in Sri Lanka(Sri Lanka College of Psychiatrists, 2014) Edrisinghe, N.; Wijesinghe, C.A.; Williams, S.S.; Kuruppuarachchi, K.A.L.A.Background Studies in Western populations indicate that the prevalence of smoking in patients with schizophrenia ranges from 70-90%. Data from low and middle income countries is sparse. Aims To determine the prevalence of smoking in patients with schizophrenia, and to identify probable ssociations. Methodology The study was conducted at the psychiatry outpatient clinics of Colombo North Teaching Hospital, Ragama. Consecutive outpatients who met ICD-10 diagnostic criteria for schizophrenia were invited to answer an interviewer administered, pre-tested questionnaire on socio-demographic status, smoking habits, disease and treatment related characteristics. The Fagerstrom’s Test for Nicotine Dependence was used to grade the level of nicotine addiction. Results Of the 400 patients with schizophrenia, 171 (42.8%) were smokers. Of them 150 (87.7%) were dependent on nicotine. In terms of Fagerstrom’s Test, high dependence was seen in 3.3% (n=5) while 39.2% (n=59) and 57.3% (n=86) reported moderate and low dependence respectively. All the smokers were male. For a majority of the patients the age of initiation of smoking was between 16-25 years, correlating with the onset of schizophrenia. Interestingly, most of the smokers (63.2%) were keen to quit smoking. Participants who smoked were significantly more likely to misuse other substances (p=0.001) and to suffer from physical illnesses (p=0.0001), compared to non-smokers. Smokers were also significantly more likely to be on intramuscular depot antipsychotics (p=0.032), whereas non-smokers in contrast, were more likely to be on atypical antipsychotics (p=0.0001). Conclusion A dual diagnosis of schizophrenia and nicotine dependence could be made in nearly half of our study population with schizophrenia. Although these rates are lower than in western populations, it is an issue that needs to be addressed in the treatment. DOI: http://dx.doi.org/10.4038/sljpsyc.v5i2.7816Sri Lanka Journal of Psychiatry Vol 5(2):19-23 Keywords: Smoking, Schizophrenia, Nicotine dependence, Substance misuse